Table 1.
Study and patient characteristics.
| References | Country | Experimental group | Control group | Sample size | The doses of therapy (weeks) | Inclusion criteria | Exclusion criteria | ||
|---|---|---|---|---|---|---|---|---|---|
| Experimental group (male/female) | Control group (male/female) | ||||||||
| Hui et al. (21) | China | Include trigone | Exclude trigone | 47 (28/19) | 44 (23/21) | 160 U detrusor + 40 U trigone | 200 U detrusor | At least 18 years old with various neurogenic disorders; urodynamic DO with urinary incontinence; an inadequate response or intolerance to oral anticholinergic drugs; participants or their caregiver could perform clean intermittent catheterization. | An allergy to BoNT-A; women were pregnant, lactating or planning to become pregnant during the course of the trial; acute urinary tract infection. |
| El-Hefnawy et al. (20) | Egypt | Include trigone | Exclude trigone | 51 (9/42) | 52 (12/40) | 100 U at 20 sites onto detrusor and trigone | 100 U at 20 sites onto detrusor | All patients had been refractory to treatment with antimuscarinics for 2 months. | Age <18 years old; neurogenic DO; evidence of obstructed urinary flow in absence of prolapse; mixed urinary incontinence; associated urethral pathology; associated bladder pathology; active UTI as evidenced by positive urine culture; and previous intravesical Botox injection. |
| Huang et al. (22) | China | Include trigone | Exclude trigone | 41 (17/24) | 39 (13/26) | 160 U detrusor + 40 U trigone | 200 U detrusor | Presence of DO and DESD; and inadequate response or intolerance to oral anti-muscarinic agent or spasmolytic agents, skeletal muscle relaxant and alpha blockers. | Allergy to BoNT-A; coagulopathy disease and myasthenia gravis; acute urinary tract infection; other causes of bladder outlet obstruction; and previous sphincterotomy. |
| Kuo (23) | China | Include trigone | Exclude trigone | 68 (31/37) | 37 (17/20) | 75 U detrusor + 25 U trigone | 100 U detrusor | Aged 18 years or more, with urodynamic DO and at least one episode of urgency or UUI per day as recorded in the 7-day voiding diary. | Neurogenic bladder, urodynamic ally confirmed bladder outlet obstruction, prior pelvic surgery, anti-incontinence surgery, or urinary tract infection. |
| Manecksha et al. (24) | Ireland | Include trigone | Exclude trigone | 11 (1/10) | 11 (2/9) | 25 U at 15 sites onto detrusor and 5 sites onto trigone | 25 U at 20 sites onto detrusor | Aged ≥17 yr with urodynamic-confirmed detrusor overactivity, who had failed ≥6 wk anticholinergic therapy or discontinued therapy due to intolerability | Infection and pregnancy; Patients previously injected with BoNT-A; Patients with any neurologic condition or coagulopathies; as were men with clinical or urodynamic evidence of bladder outflow obstruction. |
| Abdel-Meguid (25) | Egypt | Include trigone | Exclude trigone | 18 (17/1) | 18 (17/1) | 200 U detrusor + 100 U trigone | 300 U detrusor | Adults with SCI, neurogenic urinary incontinence and NDO refractory to anticholinergic medications | Patients who refused CIC or refused to discontinue anticholinergics, those who received previous BoNT-A bladder injections and those with uncontrolled urinary tract infection |
DO, detrusor overactivity; BoNT-A, botulinum toxin A; UTI, urinary tract infection; DESD, detrusor external sphincter dyssynergia; SCI, spinal cord injury; NDO, neurogenic detrusor overactivity; CIC, clean intermittent catheterization.